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Endorsement form

First Name:

Last Name:

Title (if applicable):

Organization/Business/Affiliation:

Address 1:

Address 2:

City:

State:

Zip code:

Email address: (your email address will not be shared) Reason you support this measure:

Reason you support this measure:

Support: Please select all that apply:

 I support this measure as an individual

 My business, affiliation, or organization supports this measure

Action: I am willing to take the following actions:

 Donate money

 Display a yard sign

 Volunteer to help us talk to voters

Permissions: Please select all that apply:

 I give my permission to use my name on the measure website or other materials as a supporter of the mea- sure.

 I give my permission to use the name of my organization, affiliation, or business listed above in conjunction with my name.